Second victim – patient safety incident support

Back to self help

Second victims are healthcare employees who are involved in an unanticipated adverse patient event, a medical error and/or a patient-related injury and become victimised in the sense that the employee is traumatised by the event.

Frequently, these individuals feel personally responsible for the patient outcome. Many feel as though they have let the patient down, second-guessing their clinical skills and knowledge base.  The impact on an employee involved in a patient incident can be personal and/or professional. Staff need to be supported to be self-compassionate, self-accepting, hopeful and forward looking.

General guidance to those involved in a patient incident

What is a ‘second victim’?

Second victims are healthcare employees who are involved in an unanticipated adverse patient event, a medical error and/or a patient-related injury and become victimized in the sense that the employee is traumatized by the event. Frequently, these individuals feel personally responsible for the patient outcome. Many feel as though they have let the patient down, second-guessing their clinical skills and knowledge base1.

The impact on the employee can be considered in two areas:

Personal Impact

For many healthcare employees, being involved in a significant patient safety incident is an intensely emotional time. Feelings of distress, self-doubt and fear are common and may persist long after the original incident. These may be accompanied by physical symptoms, such as sleep disturbance, or difficulty concentrating.

For some individuals, involvement in a patient safety incident contributes to the development of mental health issues, including depression, anxiety and post-traumatic stress disorder.

Professional Impact

Involvement in a patient safety incident can also affect an individual’s ongoing work in healthcare. Reduced professional confidence is common, and those involved may make defensive changes to their practice, such as avoiding similar situations or patients with similar presentations. Becoming a second victim can increase the risk of burnout, and may result in individual’s having thoughts of leaving their profession.

General guidance to support those involved in a patient safety incident

Talk to others about how you are feeling

If you have been involved in an adverse event or patient safety incident and can associate second victim phenomenon described above, remember you are not alone. It is important to talk to others, including trusted peers, line manager, staff support services and family and friends, about what happened and how you felt. This can support healing, recovery and learning following a patient safety incident.

Prompt constructive change

A healthcare employee who has experienced a patient safety incident or a near miss may wish to take constructive action to prevent further similar incidents from occurring. This might be through improving safety measures or changing a process to make it less likely that the same incident could happen again. It might be through highlighting or reducing risks as they present or through putting in place steps to mitigate the risks identified. Patient safety incidents are much less likely to occur again if there is constructive learning and changes are implemented.

To find out more and click on the resources tab below.

Further links and resources for those involved in patient incidents

Second Victim

Second Victim is a project supported by the National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC).

Second Victim provides support for healthcare employees who have experienced personal of professional impact as a result of a patient safety incident.